Dental Loupes

01/30/2013

Dental magnification loupes are fast becoming the standard of care in dentistry. They offer enhanced visualization of the operating site, reduced eyestrain, and better ergonomics. Early adopters of loupes were often self-conscious of the size and bulk of these glasses and were also concerned about patient perception. Today's dental loupes, however, are more compact and lightweight than their early predecessors. Patients are also more accepting of these devices as they realize that they provide superior visual accuracy and improved treatment outcomes.

Regardless of the brand or style that you use, wear and tear, misalignment of oculars, prescription changes, and lens scratches can adversely affect performance. Moreover, a worn out pair of loupes can lead to negative patient perceptions of in-office sterilization and hygiene practices. Here are some suggestions to keep your loupes looking and working their best.

Have you looked at your loupes lately?

In my years of outfitting dentists with occupational glasses and magnification loupes, I have seen some frightening looking nose pads. Green discoloration and build-up around nose pads results from a reaction between your skin oil and the copper and nickel components in the metal screws surrounding the pad. Silicone nose pads are quite porous and can also discolour.

Take a look at your loupes and ask yourself if you think your patient would be bothered by the appearance of your glasses. Worn-out screws, nose-pad, temple tips and headstrap should be replaced every couple of years. For day-to-day cleaning, dip a toothbrush in a solution of mild detergent and warm water and gently remove the build-up by rubbing the back surface of the pads.

Dirt and debris can also accumulate around the frame/lens interface and this is often more difficult to clean. If you are industrious, you can remove the spectacle lenses from the frame and clean the frame and lens edge surface with a toothbrush as outlined above.

For those that are more conservative, an optometrist or optician can disassemble your loops and use an ultrasonic system to professionally clean the frame. It is important to note that magnification loupes should never be soaked in any solution as water can leak between the lens elements.

Glass and plastic lens surfaces can be cleaned with an optical lens cleaner that is formulated for use with coated lens surfaces. These cleaners can be purchased at optical or drug stores. Use a lint free cloth to dry the lenses. Never polish the lenses or rub them hard with a facial tissue, as it is a wood product and the wood fibers can result in fine scratches.

To disinfect your loupes use either a quatemary ammonium disinfectant such as Cavicide, or a phenol alcohol-based spray such as Lysol.

Misalignment of oculars

Your telescopes are similar to binoculars. They must be aligned to a single target at your working distance and aligned so your pupils are directed straight through the center of each telescope to your operating sight.

With the older type of flip-up telescopes, the oculars can often become misaligned through normal wear and loosening of the screws that hold the oculars. If you experience double vision, disorientation, or eyestrain while using your loupes try to adjust the convergence angle, as outlined below.

- In your working position, focus on the operating site.

- Close one eye.

- Loosen the thumbscrews that hold the opposite telescope ocular. Center the field of view evenly by turning the ocular

- Retighten the thumbscrew.

- Repeat with the other ocular.

Frame misalignment is also responsible for symptoms of double vision, reduced visualization and end of day eyestrain. For both fixed loupe systems (also known as through-the-lens) and flip-up designs, ensure that the frames are level with your eyes.

If your frame needs adjustment, an optometrist or optician can make sure your loupes are level with your facial geometry.

Prescription Changes

If designed properly, magnification loupes are calibrated so that your eyeglass prescription is optimally matched with your working distance to the patient. If there is a mismatch between the two then there is a compromise in the performance of the telescopes. Moreover, it is important to make sure that both eyes are equally focused at the operating site. This will result in maximum depth of field, width of field, and overall visual comfort.

Make sure to have routine eye exams to determine if you need an adjustment in your spectacle lens prescription.

For those dentists over 45 years of age, presbyopia -- a condition which results in difficulty with focusing up close -- may result in eyestrain after prolonged near work. Bifocal lenses or invisible multi-focal lenses can be prescribed to correct for this condition.

If you require reading glasses in your day-to-day eye wear, then consider updating your magnification loupes to include a reading prescription.